What Is Psychodermatology?

Healthcare is a vast field, which is why every cell and organ of our body merits its own discipline and specialists. As a rule of thumb, we visit dermatologists when we have skin issues. The reason why is that dermatologists specialize in dermatology, a medical specialty involving the study, diagnosis, and treatment of the skin, hair, and nails. When we experience distressing thoughts and behaviors that spiral out of control, we see a therapist or a psychiatrist. That's because they are trained in psychology.

Just like how cells, tissues, and organs in the body build on each other, different domains in medicine are also closely related — no matter how non-relevant they seem on the surface. Such is the case of dermatology and psychology and psychiatry, which, all together, make up psychodermatology — a recently emerged discipline in psychosomatic medicine. Given that psychology and psychiatry have everything to do with the inner workings of the mind while dermatology can barely go further than skin deep, one might wonder how they can be related and how psychodermatology can contribute to advancements in dermatological treatments. Here are some insights.

It turns out that skin health and mental health are closely intertwined. Per a 2007 study published in The Primary Care Companion to The Journal of Clinical Psychiatry, psychodermatology is the study and treatment of skin disorders using psychological and psychiatric techniques by looking at the relationship between the mind and the skin. The interaction among neurological, immunological, cutaneous, and endocrine systems — collectively referred to as NICS — is what the practice of psychodermatology is based upon. When a person encounters an inflammatory skin condition and emotional distress, their NICS is destabilized.

Psychodermatology can be classified into four categories, including psychophysiological disorders, primary psychiatric disorders, secondary psychiatric disorders, and the miscellaneous. Psychophysiological disorders are skin conditions exacerbated by emotional stress like eczema, acne, or psoriasis. Primary psychiatric disorders are psychiatric conditions that result in — as opposed to result from — skin conditions. Bipolar disorder, schizophrenia, and post-traumatic stress disorder are examples of primary psychiatric disorders. Secondary psychiatric disorders are psychiatric problems brought on by skin conditions, including social phobia, frustration, and low self-esteem.

Emotions play a big role in triggering breakouts, acne can cause depression, and everything continues a vicious cycle. For instance, primary psychiatric disorders can lead to skin conditions like acne or rosacea, giving rise to secondary psychiatric disorders — feelings of shame and devastation resulting from having to deal with visible skin diseases, a 2020 study published in The Journal for Nurse Practitioners points out. So, how can specialists use psychodermatology to help patients get off this endless loop?

According to Psychotherapy.net, the goal of psychodermatology is to dig deeper into the impact of emotions on a patient's skin condition, help them overcome these emotional issues, compromise the threats, and empower the patient to create a coping strategy that will help them manage difficult emotions that might otherwise aggravate their skin condition. For instance, instead of prescribing a patient antibiotics for their recent breakout, a dermatologist trained in psychodermatology might ask the patient if they have experienced any stressful situations lately. Then, the patient might reveal that they just had a breakup and their skin health has taken a dive ever since. This information allows the dermatologist to address the root cause of the patient's skin condition and come up with an all-rounded treatment plan targeting both inner and outward healing, like meditation therapy and tips on destructive habit reversal in addition to cosmetic treatments. 

Health psychologist Dr. Heidi Williamson explains, "What young people fear most is being judged negatively for their appearance" (via The American Psychological Association). Being afraid of being judged negatively for their appearance can make young people uneasy and self-conscious, which can cost them invaluable social skills, Dr. Williamson adds. In a broader sense, psychodermatology is a holistic dermatological approach toward skin healing. Not only does the practice of psychodermatology help patients seek deeper-level solutions for their skin problems but it also helps them tackle body image insecurities and build confidence in the long run.